Madhavi-Latha Nagalla, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301103996 Issued in MI

Practice address

300 68TH St SE
Grand Rapids, MI 49548-6927

Phone

(616) 455-5000

NPI assigned

Aug 29, 2011

Last updated

Nov 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Michigan University School of MedicineGroup PAC ID 7517113954, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Western Michigan University School of Medicine

  dba WMed Health

  • Multi-Specialty Clinic/Center
  • Kalamazoo, MI
  • NPI 1316212343
  Medicare reassignment Care Compare group NPD
• Mercy Health Partners

  dba Trinity Health Medical Group

  • Family Medicine Physician
  • Hart, MI
  • NPI 1093130072
  NPD
• Mercy Health Partners

  dba Trinity Health Medical Group

  • Certified Registered Nurse Anesthetist
  • Shelby, MI
  • NPI 1154910172
  NPD
• Michigan State University Kalamazoo Center for Medical Studies

  dba Msu/KCMS

  • Multi-Specialty Clinic/Center
  • Kalamazoo, MI
  • NPI 1568467249
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bronson Methodist Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1831116441
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1295015717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH STREET SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49548",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGALLA",
        "first_name": "MADHAVI-LATHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-29",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301103996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295015717",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Patrick Naden, PHARMD
• Theodora Ruxandra Nae, PA
• Naveed Naeem, M.D.
• Lura Lynn Naessens, PT
• Riya Parul Nag, DO
• Rajeetha Nagarajah, MD
• Sachin B Nagarkar, MD
• Yuka Nagata
• Dennis W. Nagel, DDS
• Sandra Lee Nagel, MPT

• Psychiatry Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.